Purpose
The sub-internship provides students with a supervised clinical experience that builds upon the knowledge, clinical skills, and professional behaviors developed during the core clerkship in the specialty. Students function as integrated members of the inpatient healthcare team while assuming graduated responsibility for patient care under the direct supervision of attending physicians and residents.
During the sub-internship, students progressively assume responsibilities similar to those of a first-year resident while maintaining a supervised patient load appropriate to their level of training. The sub-internship emphasizes the refinement of clinical reasoning, patient assessment, diagnostic decision-making, patient management, and interprofessional communication through direct participation in the supervised care of hospitalized patients.
By the end of the sub-internship, students are expected to demonstrate the following competencies:
Communication Skills
- Communicate effectively with patients and family members with humanism and professionalism.
- Recognize verbal and non-verbal clues of a patient’s mental and physical health.
- Consider cultural sensitivities and patient wishes when providing information.
- Learn to effectively communicate with physician and non-physician members of the healthcare team and consultants.
- Demonstrate the ability to clearly and concisely present oral and written summaries of patients to members of the health care team.
Coordination of Care
- Learn to prioritize tasks for daily patient care in order to effectively utilize time.
- Learn how to contact members of the health care team, consultants, and other hospital personnel.
- Learn to identify appropriate issues for the consultant referral and how to appropriately utilize consultants.
- Effectively coordinate with physician and non-physician members of the healthcare team learn how to properly transfer care throughout a patient’s hospitalization, including end-of-day and end-of-service coverage.
- Be able to arrange appropriate care and follow-up for the patient after discharge from the hospital, including coordinating the care plan and utilizing community resources when necessary.
Information Management
- Be able to document the patient’s admission information, daily progress, on-call emergencies, transfer notes, and discharge summaries and instructions accurately and in a timely manner.
- Understand the ethical and legal guidelines governing patient confidentiality.
- Learn how to access clinical information at the hospital including clinical, laboratory and radiologic data.
- Understand how panic values are communicated from the hospital laboratory to the responsible team member.
- Understand the importance of precision and clarity when prescribing medications.
- Use electronic or paper references to access evidence-based medicine to solve clinical problems.
Procedures
- Understand the risks and benefits of common invasive procedures, and how to obtain informed consent.
- Effectively explain the rationale, risks and benefits for the procedure in language that is understandable by the patient and/or his/her family.
- Gain experience with procedures that are commonly performed by interns and residents.
- Recognize potential procedure-related risks for the operator and the need for universal precautions.
- Write a procedure note.
- Ensure that samples obtained are properly prepared for laboratory processing.